Knowing your family mental health history is as crucial for good health as knowing its physical health history. But sharing mental health information isn’t exactly light tea talk. How do you poke around without alienating good old Aunt Esther and Uncle Fred? Below are tips about how to gather the facts without busting up the clan.
Know what you’re looking for. You’re not just being nosy. You’re looking for conditions that may have a genetic component affecting you or your children, says genetic counselor Caroline Lieber, director of the Joan H. Marks Graduate Program in Human Genetics at Sarah Lawrence College in Bronxville, NY. That can include a history of depression, hospitalization for exhaustion, or schizophrenia.
Stash the fancy psychological terms. You’ll get more information (and ruffle fewer feathers) by asking more simply about behaviors, relatives who’ve lost jobs, the Uncle who “liked to drink,” and the aunt who wouldn’t eat at all. “You also want to know the age at which there were concerns,” says Lieber. “Schizophrenia, for instance, can start in young adulthood and be unrecognized for a long time.”
Be a tactful detective. “In every generation, there is someone who relays family stories,” says psychologist Simon A. Rego, director of Psychology Training at Montefiore Medical Center in the Bronx: “Start there and do a family-tree interview.” Ask questions about what each person did, and about general family health history. “Then target in on mental health questions,” says Lieber: “Ask straightforwardly, ‘Were there mental health issues like depression or substance abuse?’ ”
Circumvent resistance. If someone says the family has had no problems, ask another family member, says Lieber: “You can then go back and say, ‘Aunt Susie said this. Know anything about it?’” Rego suggests a side-door approach, asking if your relative knows other families who went through mental health difficulties, then turning the conversation to your family.
Emphasize modern acceptance. Stress how common mental health difficulties are, that they are not shameful but often genetic and that your concern is for you and your children, says Rego: “Explain that we now know a lot about prevention and half the battle is getting to things early.”
Consider genetic counseling. “Take the information you’ve gathered to a genetic counselor who will help you chart a pedigree, or family history,” says Rego. The chart allows the counselor to track patterns and to see what conditions fit the pattern. “In the world of mental illness, genetics are not well defined,” says Rego. “But if you see several generations of something like depression, it’s likely a family trait.”
